Introduction:
A known repercussion of human immunodeficiency virus (HIV) is an alteration of gait and balance, which increases the risk of fall-related injuries for those living with the disease. Muscle weakness and neurocognitive alterations can lead to distorted postural strategies in people living with HIV (PLHIV); however, the precise neuromuscular mechanism leading to this impaired postural instability remains unknown. The aim of this study was to examine the neuromuscular recruitment of lower extremities during single and dual-cognitive balance tasks among PLHIV.

Material and methods:
Fifty adults participated in this study, of whom 19 were diagnosed HIV-positive and 31 were HIV-negative. Each participant had surface electromyography electrodes placed on the tibialis anterior (TA) and gastrocnemius (GA) muscles of their dominant leg before being instructed to stand in a bi-pedal posture on a balance foam pad for 15 seconds per task. Four single balance tasks and four dual-cognitive balance tasks were performed on the foam pad.

Results:
Significant modifications in delayed and prolonged neuromuscular activation recruitment were found in both the GA and TA during single tasks, whereas dual cognitive tasks presented comparable results between the HIV group and the control group.

Conclusions:
Asymptomatic PLHIV exhibit altered neuromuscular recruitment while standing, which suggest a correlation between this evident increase in modification and a localized, peripheral issue or miscommunication between the central and peripheral nervous systems. This research highlights the necessity of conducting lower extremity neuromuscular assessments in all HIV-positive individuals.